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Bluish Skin Discoloration

Many conditions can cause your skin to become bluish in tint. For example, bruises and varicose veins can appear blue in color. Poor circulation or inadequate oxygen levels in your blood stream can also cause your skin to turn bluish. This skin discoloration is also known as cyanosis.

Cyanosis can affect your:

  • fingers, toes, and nails
  • earlobes
  • mucous membranes
  • lips
  • skin

This bluish coloring is more common in newborns as their skin learns to adjust to the environment. It’s also more noticeable on light colored skin. But cyanosis can also suggest that there’s something wrong with the lungs, heart, or circulatory system.

Most of the time, cyanosis is an indicator of a serious health condition. Read on to learn about the types of cyanosis, what causes this condition, and when you should see a doctor.

What are the types of cyanosis?

There are four types of cyanosis:

Peripheral cyanosis: When your limbs are not getting enough oxygen or blood flow due to low flow or injury

Central cyanosis: When there is low overall oxygen available to the body, often due to abnormal blood proteins or a low oxygen state

Mixed cyanosis: This happens when a combination of peripheral and central cyanosis occurs at the same time.

Acrocyanosis: Extreme cyanosis can happen around your hands and feet when you’re in the cold. This is often normal in babies, especially when it doesn’t show up anywhere else on the body. Acrocyanosis should resolve after you warm back up.

What are common causes of cyanosis?

Cyanosis occurs when there’s too little oxygen in the blood. Oxygen-rich blood is deep red and is the cause of your skin’s normal color. Under oxygenated blood is more blue and causes your skin to be bluish purple.

Cyanosis can develop quickly as a result of an acute health problem or external factor. Life threatening causes of cyanosis include:

Cyanosis can also be the result of a worsening health condition or develop gradually as a result of a chronic or long-term health condition. Many health disorders that involve the heart, lungs, blood or circulation will also cause cyanosis. These include:

  • chronic respiratory disease, such as asthma or COPD
  • sudden infection in your airways, such as pneumonia
  • severe anemia, or low red blood cell count
  • overdoses of certain medications
  • exposure to certain poisons, such as cyanide
  • Raynaud’s syndrome, a condition that can restrict blood flow to your fingers or toes
  • hypothermia, or exposure to extreme cold causing your body temperature to drop

Most causes of cyanosis are serious and a sign that your body isn’t getting enough oxygen. Over time, this condition will become life threatening. It can lead to respiratory failure, heart failure, and even death, if left untreated.

When should you seek medical attention?

Contact your doctor if you develop a bluish tint to your skin, lips, fingertips, or fingernails that can’t be explained by bruising and doesn’t go away overtime.

Seek emergency medical attention if you develop cyanosis along with any of the following symptoms:

  • difficulty breathing
  • shortness of breath
  • rapid breathing
  • chest pain
  • coughing up dark mucus
  • fever
  • confusion

How are the causes of cyanosis diagnosed?

Your doctor can diagnose cyanosis just by looking at your skin. To diagnose the cause of cyanosis, your doctor will perform a complete physical exam. They’ll ask you about your medical history including when your symptoms developed.

They may also order one or more tests, such as:

  • complete blood count (CBC)
  • pulse oximetry to measure the level of oxygen in your blood
  • electrocardiogram (ECG) to measure the electrical activity of your heart
  • echocardiogram or ultrasound of the heart
  • X-ray or CT scan of your chest

In blood tests, extremely low concentrations of hemoglobin can cause cyanosis. Central cyanosis occurs when your hemoglobin count reaches below 5 g/dL. Normal hemoglobin for an adult is between 12-17 g/dL.

How are the causes of cyanosis treated?

Your doctor’s recommended treatment plan will depend on the underlying cause of your cyanosis. Ask them for more information about your specific diagnosis and treatment options.

For example, your doctor may prescribe supplemental oxygen therapy if you have a condition that affects your airways or breathing. In this therapy, you will receive oxygen through a mask or a tube placed in your nose. Your doctor may also recommend medications, surgery, or other treatments.

For conditions that affect your heart or blood vessels, your doctor may prescribe medications, surgery, or other treatments.

If you’ve been diagnosed with Raynaud’s syndrome, your doctor may advise you to dress warmly and limit your time in cold environments.

How can you prevent cyanosis?

Some causes of cyanosis are difficult to prevent. But you can take steps to lower your risk of developing cyanosis and some conditions that cause it.

These steps include:

  • Protecting your heart, blood vessels, and respiratory system by avoiding smoking and second-hand smoke and exercising regularly.
  • Scheduling regular check-ups with your doctor to monitor your health and contact them if you notice any changes in your health.
  • Following your doctor’s recommended treatment plan for any health conditions that you have, such as diabetes, heart disease, Reynaud’s syndrome, asthma, or COPD.
  • Wearing more layers and warmer clothes during winter time.
  • Get vaccinated to prevent respiratory infections and serious illnesses.

Content licensed from:

Written by: Darla Burke
Medically reviewed on: Nov 10, 2016: Judith Marcin, MD

This feature is for informational purposes only and should not be used to replace the care and information received from your health care provider. Please consult a health care professional with any health concerns you may have.
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